Risk of Vaccine Breakthrough SARS-CoV-2 Infection and Associated Factors in Healthcare Workers of Trieste Teaching Hospitals (North-Eastern Italy)

Abstract

Background: Healthcare workers (HCWs) are particularly exposed to biological risk, including SARS-CoV-2 infection. In order to contrast the current pandemic and alleviate the burden of the disease on the healthcare system, a mass vaccination campaign against COVID-19 has been launched worldwide. Aim To evaluate the impact of COVID-19 vaccination in HCWs exposed to SARS-CoV-2, to describe the clinical presentation of COVID-19 in infected HCWs, and to investigate clinical and occupational risk factors for breakthrough infection. Design: Retrospective cohort study. Methods: The cohort of HCWs of Trieste Hospitals were followed up from 1 March 2020, to 30 November 2021 (21 months). All HCWs were periodically screened for SARS-CoV-2 infection by real-time PCR (RT–PCR) analysis. Clinical data were obtained through routine medical surveillance records. Risk factors for SARS-CoV-2 infection were investigated by univariable as well as multivariable logistic regression analysis. Results: Among 4394 HCWs routinely screened for SARS-CoV-2 by PCR on nasopharyngeal swab, a total of 800 incident cases were identified during the entire study period (1 March 2020 to 30 November 2021). Five hundred and sixty-four cases occurred before, and 236 after the start of the vaccination campaign against COVID-19, of whom 155 received a complete vaccination scheme before SARS-CoV-2 infection. Breakthrough infection was featured by mild or no symptoms and was significantly associated with the male sex, BMI > 25, and diabetes mellitus. Some categories of HCWs (physicians and nurse aids/auxiliary personnel) were at a higher risk of breakthrough infection. Conclusions: Fully vaccinated HCWs were less likely to acquire symptomatic as well as asymptomatic SARS-CoV-2 infection. Risk factors for SARS-CoV-2 infection after a full COVID-19 vaccination scheme included the male gender, diabetes mellitus, and overweight. HCWs with higher exposure to COVID-19 patients were at higher risk of breakthrough infection.

Occupational Risk Factors for SARS-CoV-2 Infection in Hospital Health Care Workers: A Prospective Nested Case-Control Study

“…Furthermore, occupation was not a significant risk factor in the present study, which is in line with some studies investigating the risk of both NPSs positivity [32] and seropositivity [18,23,38,39]. Some authors identified a decreased risk for doctors and nurses and an increased risk for technicians and sanitation workers [16,28,40] although another study from Trieste teaching hospitals found a higher risk of SARS-CoV-2 infection in nurse aides/auxiliary personnel and a lower risk for technicians [41]. The lack of significance could be related to our inclusion criteria, which only allowed recruitment of HCWs exposed to COVID-19 patients, thus exposed to high risk of infection regardless of job task.…”

Dynamics of SARS-CoV-2 Variants of Concern in Vaccination Model City in the State of Sao Paulo, Brazil

“…We believe that reduced lethality in Serrana was probably due to the anticipated vaccination program, where, by this time, 80.1% of the adult population was vaccinated. The beneficial effects of the vaccination were also observed in other studies where fully vaccinated individuals were less likely to acquire symptomatic or asymptomatic infections [ 27 ]. Therefore, the COVID-19 vaccination shows beneficial effects in reducing the SARS-CoV-2-related infection rates, severe cases, and mortality.…”

Risk Factors Associated With SARS-CoV-2 Breakthrough Infections in Fully mRNA-Vaccinated Individuals: Retrospective Analysis

“…Given the concerns about vaccine breakthrough infections [ 20 ], studies have been conducted to confirm vaccine breakthrough infections with SARS-CoV-2 variants using genome sequencing [ 16 ] and to investigate clinical characteristics of the vaccine breakthrough infections [ 21 - 23 ]. Early reports have found breakthrough infections more often occur in individuals with solid organ transplants [ 24 - 27 ], obesity [ 28 ], hypertension [ 29 ], diabetes [ 29 , 30 ], congestive heart failure [ 29 , 31 ], chronic kidney disease (CKD) [ 22 , 32 ], lung diseases [ 33 ], dementia [ 34 ], and cancer [ 22 , 35 - 37 ]. Here, we retrospectively analyzed electronic health records (EHRs) from the Columbia University Irving Medical Center/New York Presbyterian (CUIMC/NYP) up to September 21, 2021, to systematically identify risk factors associated with breakthrough infections among fully messenger RNA (mRNA)–vaccinated individuals.…”